I am a certified mediator and I recently mediated a workers' compensation claim for some local lawyers. The injured worker in the case alleged that she hurt her foot on a piece of equipment at work. Her supervisor claimed that the woman told the supervisor that she had gotten hurt at home. Normally, this type of dispute would be a "swearing match" with both people testifying under oath in court, and the Deputy Commissioner would have to figure out who was telling the truth. Having a document to clarify the facts either way is a big help in this kind of situation.
I get calls frequently from unrepresented injured workers who have been "rated and released" by their treating physicians. The term "rated and released" means that the worker has reached "MMI" (maximum medical improvement) and the doctor has provided a "permanent partial disability rating" and released the patient from treatment, either with or without work restrictions. Under the NC Workers' Compensation Act, and specifically NC General Statute section 97-31, that rating--expressed as a percentage of a body part--translates into a certain amount of money for the patient, based on the body part, percentage assigned, and the compensation rate in the case. For example, a broken wrist with a healed ORIF may result in a PPD rating of 15%, which would be 15% of the "hand" (the "hand" is everything distal to the elbow, down to the fingers). The hand is a 200 week body part, so 15% of the hand is worth 200 x .15 = 30 weeks of the compensation rate. A worker who made $600 per week in gross pay before the injury would have a compensation rate of $400. Using that comp rate, a 15% to the hand would be worth 30 times $400, which equals $12,000, paid out (after Industrial Commission approval) over the 30 weeks that immediately follow the rating and release date. The injured worker also has the right to get a second opinion on the percentage amount of the PPD rating.
A new client showed me a letter today that was sent to the client by the workers' compensation insurance adjuster. She received this letter a few days after the client reported her injury to her employer.
I spent my morning today in court, trying a workers' comp case. The insurance company and employer were hoping to stop my client's weekly TTD--temporary total disability-- checks, on the basis that he either had returned to work or should have returned to work by now.
An injured worker is entitled to represent himself in court or in a workers' comp claim in North Carolina. Is it a good idea?
When an employee in North Carolina reports an on-the-job injury to his or her employer, the employer will usually report it to the insurance carrier for investigation. At that point the insurance adjuster assigned to the claim will begin interviewing witnesses, including the injured worker. These adjusters typically call the injured worker on the phone and ask to take a "recorded statement" as part of the initial investigation of the case.
The Arkansas Court of Appeals recently allowed Facebook photos of a man partying and drinking to be used against him in a workers' compensation hearing. The man had claimed to have constant severe pain from his injury, and the court ruled that the photos he (or one of his friends) had posted on Facebook of him having a big 'ol time were admissible in court to show that he really was not in so much pain after all.